Original Article |

Effects of Salivary Bypass Tubes on Fistula and Stricture Formation

Xerxes Punthakee, MD; Soroush Zaghi, MD; Vishad Nabili, MD; P. Daniel Knott, MD; Keith E. Blackwell, MD
JAMA Facial Plast Surg. 2013;15(3):219-225. doi:10.1001/jamafacial.2013.791.
Text Size: A A A
Published online

Importance Stricture and fistula formation are two of the most common long-term complications of free flap reconstruction of hypopharyngeal defects.

Objective To examine the effects of salivary bypass tubes (SBTs) on fistula and stricture formation after free flap reconstruction of hypopharyngeal defects.

Design Retrospective cohort study.

Setting Academic tertiary care medical center.

Participants A total of 103 consecutive patients who underwent hypopharyngeal free flap reconstruction.

Intervention Use of salivary bypass tube.

Main Outcome Measure Fistula and stricture formation.

Results The overall fistula and stricture rates were 14.6% and 27.2%, respectively. Subgroup analysis revealed fistula rates of 7.4% in patients who received SBTs and 22.4% in those who did not (P = .048). However, no statistically significant difference between the two groups was shown with multivariate analysis. The unadjusted stricture rate was 30.6% without vs 24.1% with SBT placement (P = .51).

Conclusions and Relevance Univariate analysis showed that SBT placement significantly reduced the risk of fistula in this population. Larger multicenter studies are needed to further explore the benefits of SBT use in preventing fistula and stricture formation.

Level of Evidence 3.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles